Archives: November 2015

November 2015 Newsletter

Conversation Starter: Effects of Defensive Medicine on Liability Claims As the sky high cost of ordering more tests than is medically necessary further adds to the burden of an already expensive health care system, researchers in an initial study of defensive medicine opened the door to further analysis on how health care spending is linked to a reduction in liability lawsuits. The British Medical Journal study, focusing on physicians practicing in Florida between 2000 and 2010, saw a correlation between individual physicians’ rapid rise in spending and their likelihood of being sued. Among doctors in six out of seven specialties, those in the highest fifth of spending had the lowest rates of liability claims. Similar associations were seen among pediatricians, surgeons, and obstetricians, with no association noted for family physicians. An editorial accompanying the study urges readers not to jump to conclusions that the cure for liability reform is in fact piling on unnecessary tests and procedures. “It may be tempting for doctors to use the results to justify ordering unnecessary tests and procedures to reduce their risk of malpractice claims. Instead, we should consider Jena and colleagues’ study as a contribution to our understanding of the risk of such…

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Costly Mistakes: How Bad Policies Raise the Cost of Living

Government policy mistakes raise the prices of the things that Americans buy. An average American household can expect to pay an extra $4,440 each year thanks to just 12 such policy mistakes that have large costs and few benefits. Local, state, and federal governments are all guilty of enforcing costly laws and regulations. At the federal level, the biggest costs come from vehicle fuel-efficiency standards, which cost consumers $55 billion a year, and the requirement to use corn-based ethanol in gasoline, which costs $31 billion per year. Occupational licensure at the state level costs consumers $127 billion per year. Local land-use restrictions drive up the cost of housing by $209 billion per year. Altogether, the 12 policy mistakes quantified in this paper cost Americans $546 billion per year or 4.6 percent of total consumption. That is comparable to the Department of Defense budget and 18 times the budget of the National Institutes of Health. It is more than half as much as Americans spend on groceries, and more than the rent paid by every renter in America. It is three times the budget of the State of California. It is more than what 14 million average Americans spend in a…

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High-spending doctors less likely to be sued

Providing more care than necessary may work to lower a doctor’s risk of being accused of malpractice, suggests a new U.S. study. Although the results can’t prove extra expenditures are due to so-called defensive medicine, the researchers found that doctors in Florida who provided the most costly care between 2000 and 2009 were also least likely to be sued between 2001 and 2010. “By no means would I consider it to be conclusive, but it does signal to us that defensive medicine could work in lowering malpractice risk, but more research is needed to know if that’s true or not,” said lead author Dr. Anupam Jena, of Massachusetts General Hospital and Harvard Medical School in Boston. He and his colleagues write in The BMJ that critics of the U.S. malpractice system suggest it encourages defensive medicine, which is when doctors provide more healthcare than necessary in order to stave off lawsuits. “If you ask physicians what’s the number one concern they have when you talk to them about their careers, I would say malpractice will come up as one of their top concerns,” Jena said. While it’s commonly accepted that doctors practice defensive medicine, the researchers write, no studies have…

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